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Primary bile acid diarrhea (Type 2 bile acid "malabsorption") may be caused by an overproduction of bile acids. [ 5 ] [ 9 ] Several groups of workers have failed to show any defect in ileal bile acid absorption in these patients, and they have an enlarged bile acid pool, rather than the reduced pool expected with malabsorption. [ 10 ]
Chronic diarrhea in postcholecystectomy syndrome is a type of bile acid diarrhea (type 3). [3] This can be treated with a bile acid sequestrant like cholestyramine, [3] colestipol [2] or colesevelam, [7] which may be better tolerated. [8]
Generally, diseases outlined within the ICD-10 codes K55-K63 within Chapter XI: Diseases of the digestive system should be included in this category. Subcategories This category has the following 2 subcategories, out of 2 total.
The glycocholic acid breath test involves the administration of the bile acid 14 C glycocholic acid, and the detection of 14 CO 2, which would be elevated in bacterial overgrowth. [ citation needed ] However, some physicians suggest that if the suspicion of bacterial overgrowth is high enough, the best diagnostic test is a trial of treatment.
[10] [11] In this setting, microcytic anaemia usually implies iron deficiency and macrocytosis can be caused by impaired folic acid or B12 absorption or both. Low cholesterol or triglyceride may give a clue toward fat malabsorption. [12] Low calcium and phosphate may give a clue toward osteomalacia from low vitamin D. [12]
When bile enters the duodenum (the first part of the small intestine), it aids in digesting the fat within food leaving the stomach. When the bile can not be properly propelled from the not-mechanically-obstructed gallbladder or can not flow out of the end of the common bile duct properly, there is a state of biliary dyskinesia.
Without bile acids, this pathway would have a hard time occurring, which would lead to fat malabsorption and make steatorrhea more probable to occur. [2] Other features of fat malabsorption may also occur such as reduced bone density, difficulty with vision under low light levels, bleeding, bruising, and slow blood clotting times.
Persons with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in vitamins A, D, E, K, B 9 (folic acid), and B 12, calcium, magnesium, iron, and zinc. These may appear as anemia, hyperkeratosis (scaling of the skin), easy bruising, muscle spasms, poor blood clotting, and bone pain.